scholarly journals Comparison of Staphylococcus Aureus Endocarditis Risk Factors With Bacteremia

Author(s):  
Majid Khani Ghale ◽  
Monireh Kamali ◽  
Yasamin Khosravani-Nezhad ◽  
Mehrangiz Zangeneh

Abstract Introduction: Infective endocarditis (IE) is endothelial damage of the endocardium, which is caused by infection. The etiologic agents' highest mortality and morbidity rates are associated with staphylococcus aureus (S. aureus). Accordingly, the knowledge of different risk factors for IE caused by the S. aureus is necessary.Material and methods: This study is an observational-analytical retrospective cohort study on 139 patients with staphylococcus aureus bacteremia (SAB), who referred to a cardiac center during 2011-2019. This study aimed to evaluate the risk factors in 48 patients with staphylococcus aureus endocarditis, who were selected from139 patients with S. aureus bacteremia. Results: The mean age (±SD) of the patients is 56.61 (±16.58), and85 (61.2%) persons are male. Forty-eight patients (34.5%) are diagnosed with staphylococcus aureus endocarditis regarding Duke criteria. In this study, the following risk factors were significantly associated with S. aureus endocarditis: age (p=0.003), long-term bacteremia (p=0.041), prosthetic heart valve (p=0.016), pre-existing IE (p=0.048), and embolic events (p=0.039).Conclusion: According to the findings, a significant number of patients with staphylococcus aureus bacteremia (SAB) have IE with different risk factors. Future studies with a larger sample size are recommended to detect IE risk factors.

2002 ◽  
Vol 323 (3) ◽  
pp. 117-123 ◽  
Author(s):  
Nilton A. Rezende ◽  
Henry M. Blumberg ◽  
Susan M. Ray ◽  
Brian S. Metzger ◽  
Nina M. Larsen ◽  
...  

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S109-S110
Author(s):  
Charles Hoffmann ◽  
Gordon Watkins ◽  
Patrick DeSimone ◽  
Peter Hallisey ◽  
David Hutchinson ◽  
...  

Abstract Background Staphylococcus aureus bacteremia (SAB) is associated with 30-day all-cause mortality rates approaching 20–30%. The purpose of this case–control study was to evaluate risk factors for 30-day mortality in patients with SAB at a community hospital. Methods As part of an antimicrobial stewardship program (ASP) initiative mandating Infectious Diseases consultation for episodes of SAB, our ASP prospectively monitored all cases of SAB at a 341-bed community hospital in Jefferson Hills, PA from April 2017–February 2019. Cases included patients with 30-day mortality from the initial positive blood culture. Only the first episode of SAB was included; patients were excluded if a treatment plan was not established (e.g., left against medical advice). Patient demographics, comorbidities, laboratory results, and clinical management of SAB were evaluated. Inferential statistics were used to analyze risk factors associated with 30-day mortality. Results 100 patients with SAB were included; 18 (18%) experienced 30-day mortality. Cases were older (median age 76.5 vs. 64 years, P < 0.001), more likely to be located in the intensive care unit (ICU) at time of ASP review (55.6% vs. 30.5%, P = 0.043), and less likely to have initial blood cultures obtained in the emergency department (ED) (38.9% vs. 80.5%, P < 0.001). Variables associated with significantly higher odds for 30-day mortality in univariate analysis: older age, location in ICU at time of ASP review, initial blood cultures obtained at a location other than the ED, and total Charlson Comorbidity Index (CCI). Variables with P < 0.2 on univariate analysis were analyzed via multivariate logistic regression (Table 1). Conclusion Results show that bacteremia due to MRSA and total CCI were not significantly associated with 30-day mortality in SAB, whereas older age was identified as a risk factor. Patients with initial blood cultures obtained at a location other than the ED were at increased odds for 30-day mortality on univariate analysis, which may raise concern for delayed diagnosis. Disclosures All authors: No reported disclosures.


2008 ◽  
Vol 27 (5) ◽  
pp. 396-399 ◽  
Author(s):  
Allison C. Ross ◽  
Philip Toltzis ◽  
Mary Ann OʼRiordan ◽  
Leah Millstein ◽  
Troy Sands ◽  
...  

2008 ◽  
Vol 36 (2) ◽  
pp. 118-122 ◽  
Author(s):  
Fu-Der Wang ◽  
Yin-Yin Chen ◽  
Te-Li Chen ◽  
Cheng-Yi Liu

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S199-S199
Author(s):  
Julia Marshall ◽  
Vance G Fowler ◽  
Felicia Ruffin ◽  
Paul Lantos ◽  
Christopher Timmins

Abstract Background Risk factors for community-associated Staphylococcus aureus bacteremia (SAB) are incompletely understood. We used Geographic Information Systems (GIS) and spatial statistics to analyze demographic and geographic epidemiology of SAB in the community. Methods We used the S. aureus Bacteremia Group Prospective Cohort Study (SABG-PCS) at Duke University Medical Center to obtain demographic and clinical data. We used the American Community Survey and U.S. Census to supply neighborhood variables. Secular trends in demographic and clinical characteristics of SAB patients prospectively enrolled between 1995 and 2015 (n = 2478) were determined using linear regressions. To characterize spatial patterns in Methicillin-resistant S. aureus (MRSA) bacteremia compared to Methicillin-susceptible S. aureus (MSSA) bacteremia, we used GIS mapping and selected a subgroup of patients (n = 667) living in and around Durham County, North Carolina. We then created generalized additive models (GAMs) using this subgroup to detect geographic heterogeneities in probabilities of MRSA infections compared to MSSA infections. Results We found evidence of changing demographic and clinical characteristics of SAB patients over the 21-year period. The proportion of infections acquired in the community increased significantly (p &lt; 0.0001). However, we did not detect spatial heterogeneities of MRSA infections in Durham County. Patient location of residence was not significantly associated with antimicrobial-resistant infections. Patient age and year of hospital admission were the only statistically significant covariates in our spatial models. Conclusion We utilized a novel method to analyze SAB in the community using GIS and spatial statistics. Future research should prioritize community transmission of S. aureus to identify robust risk factors for infection. Disclosures Vance G. Fowler, Jr., MD, MHS, Achaogen (Consultant)Advanced Liquid Logics (Grant/Research Support)Affinergy (Consultant, Grant/Research Support)Affinium (Consultant)Akagera (Consultant)Allergan (Grant/Research Support)Amphliphi Biosciences (Consultant)Aridis (Consultant)Armata (Consultant)Basilea (Consultant, Grant/Research Support)Bayer (Consultant)C3J (Consultant)Cerexa (Consultant, Other Financial or Material Support, Educational fees)Contrafect (Consultant, Grant/Research Support)Debiopharm (Consultant, Other Financial or Material Support, Educational fees)Destiny (Consultant)Durata (Consultant, Other Financial or Material Support, educational fees)Genentech (Consultant, Grant/Research Support)Green Cross (Other Financial or Material Support, Educational fees)Integrated Biotherapeutics (Consultant)Janssen (Consultant, Grant/Research Support)Karius (Grant/Research Support)Locus (Grant/Research Support)Medical Biosurfaces (Grant/Research Support)Medicines Co. (Consultant)MedImmune (Consultant, Grant/Research Support)Merck (Grant/Research Support)NIH (Grant/Research Support)Novadigm (Consultant)Novartis (Consultant, Grant/Research Support)Pfizer (Grant/Research Support)Regeneron (Consultant, Grant/Research Support)sepsis diagnostics (Other Financial or Material Support, Pending patent for host gene expression signature diagnostic for sepsis.)Tetraphase (Consultant)Theravance (Consultant, Grant/Research Support, Other Financial or Material Support, Educational fees)Trius (Consultant)UpToDate (Other Financial or Material Support, Royalties)Valanbio (Consultant, Other Financial or Material Support, Stock options)xBiotech (Consultant)


Author(s):  
Seong-Ho Choi ◽  
Michael Dagher ◽  
Felicia Ruffin ◽  
Lawrence P Park ◽  
Batu K Sharma-Kuinkel ◽  
...  

Abstract Background To understand the clinical, bacterial, and host characteristics associated with recurrent Staphylococcus aureus bacteremia (R-SAB), patients with R-SAB were compared to contemporaneous patients with a single episode of SAB (S-SAB). Methods All SAB isolates underwent spa genotyping. All isolates from R-SAB patients underwent pulsed-field gel electrophoresis (PFGE). PFGE-indistinguishable pairs from 40 patients underwent whole genome sequencing (WGS). Acute phase plasma from R-SAB and S-SAB patients was matched 1:1 for age, race, sex, and bacterial genotype, and underwent cytokine quantification using 25-analyte multiplex bead array. Results R-SAB occurred in 69 (9.1%) of the 756 study patients. Of the 69 patients, 30 experienced relapse (43.5%) and 39 reinfection (56.5%). Age, race, hemodialysis dependence, presence of foreign body, methicillin-resistant Staphyloccus aureus, and persistent bacteremia were individually associated with likelihood of recurrence. Multivariate risk modeling revealed that black hemodialysis patients were nearly 2 times more likely (odds ratio [OR] = 9.652 [95% confidence interval [CI], 5.402–17.418]) than white hemodialysis patients (OR = 4.53 [95% CI, 1.696–10.879]) to experience R-SAB. WGS confirmed PFGE interpretations in all cases. Median RANTES (regulated on activation, normal T cell expressed and secreted) levels in acute phase plasma from the initial episode of SAB were higher in R-SAB than in matched S-SAB controls (P = .0053, false discovery rate &lt; 0.10). Conclusion This study identified several risk factors for R-SAB. The largest risk for R-SAB is among black hemodialysis patients. Higher RANTES levels in R-SAB compared to matched controls warrants further study.


2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Poorani Sekar ◽  
James R. Johnson ◽  
Joseph R. Thurn ◽  
Dimitri M. Drekonja ◽  
Vicki A. Morrison ◽  
...  

Abstract Background Echocardiography is fundamental for diagnosing infective endocarditis (IE) in patients with Staphylococcus aureus bacteremia (SAB), but whether all such patients require transesophageal echocardiography (TEE) is controversial. Methods We identified SAB cases between February 2008 and April 2012. We compared sensitivity and specificity of transthoracic echocardiography (TTE) and TEE for evidence of IE, and we determined impacts of IE risk factors and TTE image quality on comparative sensitivities of TTE and TEE and their impact on clinical decision making. Results Of 215 evaluable SAB cases, 193 (90%) had TTE and 130 (60%) had TEE. In 119 cases with both tests, IE was diagnosed in 29 (24%), for whom endocardial involvement was evident in 25 (86%) by TEE, vs only 6 (21%) by TTE (P &lt; .001). Transesophageal echocardiography was more sensitive than TTE regardless of risk factors. Even among the 66 cases with adequate or better quality TTE images, sensitivity was only 4 of 17 (24%) for TTE, vs 16 of 17 (94%) for TEE (P &lt; .001). Among 130 patients with TEE, the TEE results, alone or with TTE results, influenced treatment duration in 56 (43%) cases and led to valve surgery in at least 4 (6%). It is notable that, despite vigorous efforts to obtain both tests routinely, TEE was not done in 86 cases (40%) for various reasons, including pathophysiological contraindications (14%), patient refusal or other patient-related factors (16%), and provider declination or system issues (10%). Conclusions Patients with SAB should undergo TEE when possible to detect evidence for IE, especially if the results might affect management.


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